The incidence and descriptive factors of calcaneal malunion after surgical fixation of intra-articular calcaneal fractures using the sinus tarsi approach: A retrospective cohort study with binary logistic regression analysis
Issued Date
2026-01-01
Resource Type
ISSN
12687731
eISSN
14609584
Scopus ID
2-s2.0-105034449968
Journal Title
Foot and Ankle Surgery
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SCOPUS
Bibliographic Citation
Foot and Ankle Surgery (2026)
Suggested Citation
Tharmviboonsri T., Harnroongroj T., Wannawongtikul C., Chuckpaiwong B., Lertwattanachai P., Kanjanakeereewong I. The incidence and descriptive factors of calcaneal malunion after surgical fixation of intra-articular calcaneal fractures using the sinus tarsi approach: A retrospective cohort study with binary logistic regression analysis. Foot and Ankle Surgery (2026). doi:10.1016/j.fas.2026.03.009 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116084
Title
The incidence and descriptive factors of calcaneal malunion after surgical fixation of intra-articular calcaneal fractures using the sinus tarsi approach: A retrospective cohort study with binary logistic regression analysis
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Abstract
Background This study evaluated the incidence of calcaneal malunion after minimally invasive sinus tarsi approach (MIS-STA) in displaced intra-articular calcaneal fractures (I-ACFs) and identified related descriptive factors of calcaneal malunion. Methods A retrospective review of 99 displaced I-ACFs treated with MIS-STA was conducted. Demographic data, pre-operative radiographs, and operative details were analyzed. Outcomes included numerical rating scale (NRS) pain scores at rest and during activities of daily living (ADL), Foot and Ankle Ability Measure (FAAM) for ADL and radiographic parameters. Logistic regression was used to identify descriptive factors associated with malunion. Results Malunion occurred in 33/99 cases (33.3%). The significant descriptive factors were the initial Böhler angle < 0.5 °, time to surgery > 12.5 days, and Sanders type ≥ III. Malunion patients had significantly worse NRS and FAAM scores (p ≤ 0.001). Conclusion Calcaneal malunion after MIS-STA occurred in one-third of cases, with three descriptive factors identified and poorer outcomes observed. Level of evidence III, Comparative retrospective study with binary logistic regression analysis